Provider Demographics
NPI:1003246604
Name:SYNOVEC, CAITLIN EMMA (OTR/L)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:EMMA
Last Name:SYNOVEC
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3327 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2623
Mailing Address - Country:US
Mailing Address - Phone:407-716-0528
Mailing Address - Fax:
Practice Address - Street 1:421 FALLSWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-4800
Practice Address - Country:US
Practice Address - Phone:407-716-0528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06641225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health